Individual provider Active NPI

Collin Thomas Welteroth, DO

  • Student in an Organized Health Care Education/Training Program
  • Wilmington, NC
National Provider Identifier
1700637790
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
416 N 30TH St
Wilmington, NC 28405-3158
Phone
(910) 833-9175
Fax
(910) 833-9159
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

416 N 30TH St
Wilmington, NC 28405-3158

Mailing address

416 N 30TH St
Wilmington, NC 28405-3158
Phone (910) 833-9175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731004187 NC Order and Referring Only - PsychiatryPractitioner - Psychiatry 1355888967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: cwelteroth1535631@direct.novanthealth.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1700637790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N 30TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053158",
            "telephone_number": "910-833-9175",
            "fax_number": "910-833-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N 30TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053158",
            "telephone_number": "910-833-9175",
            "fax_number": "910-833-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELTEROTH",
        "first_name": "COLLIN",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.